Is there such a thing as the history of the body, and, if so, how might we study it? The idea of the body as a constant, a given, whose components and attributes must always be there to be known or discovered, seems self-evident to the medical patient, the medical practitioner, the micro-biologist of the present day. Much writing in medical history takes it for granted that our current approaches to knowing and describing the body correspond exactly to an objective reality which has been unchanging over time, and that matching the medical treatises and descriptions of past eras against this reality is an unproblematic exercise.

Barbara Duden argues strongly that this is a simplistic view which, at the very least, makes it impossible for us to understand either the medical practice of the past or the changing ways in which the body has been experienced; it also blinds us to the fact that even modern, ‘scientific’ medical terminology reifies as objective physical states and processes what are more properly seen as subjective intellectual constructs. And she wishes us to go further still and to ‘start from the assumption that the imagination and perceptions of a given period have the power to generate reality.’

The title of her book in the original German edition is Geschichte unter der haut, which Harvard University Press has translated as The Woman beneath the Skin. The implication that where history is, woman is not, and where woman is, history is not, is in this case quite peculiarly inappropriate. Duden’s minute study of the case histories collected by the Eisenach physician Johann Storch in his eight volumes on the diseases of women published between 1747 and 1752 is not only a major essay in the historiography of the 18th century, but one which demonstrates the relative insignificance of gender as a defining category in this period.

Storch was born in 1681 in a village of six hundred inhabitants where both his father and grandfather had practised as tailors, local healers and dealers in herbs and medicines. Unlike them, he studied medicine at the University of Jena, where he undertook the dissection of cadavers, and was exposed to the ‘progressive’ theories of Georg Ernst Stahl, Wolfgang Wedel and Friedrich Hoffmann, all of whom were concerned to question traditional doctrines of the humours. The University licensed him as a practitioner, and he settled in Eisenach to build up a professional career.

What his case histories demonstrate is how little impact Storch’s anatomical training had on his subsequent perceptions of physiological processes. As Duden puts it, ‘the dead body did not yet cast its shadow on the living body.’ What lay beneath the skin ‘could be grasped only as the place of an experienced but invisible flowing’. This benign flow found outlets not only in conventional orifices, but in wounds, lumps and pores. Substances like breast milk were credited with the capacity to move about the body and to undergo constant metamorphoses – into faeces, a rash, an inflammation. These were all forms of ‘humoral matter’; and they manifested the healing power of nature, and its invisible intentionality.